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NPI Code Detail

MEDICARE: JILL ELIZABETH MCCOLGAN MS OTR/L

MEDICARE: JILL ELIZABETH MCCOLGAN MS OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist9741CA
2225X00000XOccupational Therapist09366MA
3225X00000XOccupational Therapist072.0134192VT

General Provider Information

NPI Number : 1588849053
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL ELIZABETH MCCOLGAN MS OTR/L
Provider Business Mailing Address
First Line : 209 AUSTINE DR
Second Line :
City : BRATTLEBORO
State : VT
Zip : 05301-7223
Country : US
Telephone Number : 802-257-7852
Fax Number :
Provider Business Practice Location Address
First Line : 2707 PINE ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-2522
Country : US
Telephone Number : 415-563-7600
Fax Number : 415-563-6732
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2008
Last Update Date : 09/19/2022

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